Fri Oct 28 2022

66 articles - From Friday Oct 21 2022 to Friday Oct 28 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Clin Gastroenterol Hepatol

The Predictive Performance of Contemporary Guideline Recommendations for Helicobacter pylori Testing in a United States Population.

In this contemporary U.S. cohort, the performance of individual risk factors identified by the Houston Consensus Conference and ACG was generally low for predicting H. pylori infection, except for Black or Hispanic race/ethnicity and first-generation immigrant status. A risk prediction model combining several risk factors had improved diagnostic performance and should be validated in future studies.

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Endoscopy

Expected value of artificial intelligence in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

(8) For acceptance of AI optical diagnosis (computer-aided diagnosis [CADx]) of diminutive polyps (=5 mm), AI-assisted characterization should match performance standards for implementing resect-and-discard and diagnose-and-leave strategies. (9) For acceptance of AI in the management of polyps =6mm, AI-assisted characterization should be comparable to that of experienced endoscopists in selecting lesions amenable to endoscopic resection.

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Gastroenterology

AGA Clinical Practice Guideline on Pharmacological Interventions for Adults With Obesity.

In adults with overweight and obesity who have an inadequate response to lifestyle interventions alone, long-term pharmacological therapy is recommended, with multiple effective and safe treatment options.

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GI Multisociety Strategic Plan on Environmental Sustainability.

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Gastrointest Endosc

GI multisociety strategic plan on environmental sustainability.

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Meta-analysis

meta-analyses and systematic reviews

Clin Gastroenterol Hepatol

Response and Adverse Event Rates with Placebo in Gastroparesis: A Systematic Review and Meta-analysis.

This meta-analysis assessed placebo response and adverse event rates in gastroparesis. To accurately assess therapeutic gain, future trials should be a minimum of 8 weeks duration, use validated questionnaires, and distinguish gastroparesis subtypes.

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Gastrointest Endosc

Occurrence of Gastric Cancer in Patients with Juvenile Polyposis Syndrome: A systematic review and meta-analysis.

GC is highest in SMAD4-associated JPS and was not reported in patients without identifiable PGVs. The value of GC surveillance in BMPR1A PGV carriers and JPS patients without an identifiable PGV is questionable. Germline testing should be performed in al JPS patients to inform GC risk discussion and utility of surveillance.

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Neurogastroenterol Motil

Brain effect of transcutaneous vagal nerve stimulation: A meta-analysis of neuroimaging evidence.

Brain effects of tVNS localize to regions associated with both physiological autonomic regulation and regions whose activity is modulated across numerous FGIDs, which may provide a neural basis for efficacy of this treatment. Functional activity differences between sham and null stimulation illustrate the importance of robust control procedures for future trials.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

A prospective pilot study of a gluten-free diet for primary sclerosing cholangitis and associated colitis.

This study did not demonstrate a clinical improvement with short-term GFD in patients with PSC-IBD. However, a gluten/ATI-free diet may improve biomarkers of intestinal inflammation and barrier function in these patients with associated with changes in the enteric microbiota. Further investigation of the therapeutic potential of gluten-free diets in PSC-IBD is warranted.

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Clinical assessment of suspected drug-induced liver injury and its management.

The diagnosis of DILI is challenging and is primarily made through a carefully crafted patient interview, temporal relationship with the implicated drug or supplement, and exclusion of competing aetiology. LiverTox is a useful resource for clinicians to review the literature and recognise the likelihood of the implicated agent in causing DILI.

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Effect of risankizumab on health-related quality of life in patients with Crohn's disease: results from phase 3 MOTIVATE, ADVANCE and FORTIFY clinical trials.

Risankizumab induction therapy (600 or 1200mg IV) led to clinically meaningful improvements in disease-specific and general patient-reported outcomes, including fatigue, in patients with moderate to severe Crohn's disease. These improvements were sustained after 52weeks of risankizumab (180 or 360mg SC) maintenance therapy.

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Effectiveness and safety of tofacitinib for ulcerative colitis: two-year results of the ICC Registry.

Tofacitinib was effective in 31.8% of patients after 24months of treatment.

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Impact of advanced practice providers on characteristics and quality of care of patients with chronic hepatitis B.

Treatment-eligible patients with CHB receiving APP care were more likely to receive antiviral therapy. APP care may help to expand the pool of providers for patients with CHB, and to improve current suboptimal treatment rates.

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Liver resection versus microwave ablation for hepatocellular carcinoma in ideal candidates for ablation per Barcelona Clinic Liver Cancer staging: a propensity score matching and inverse probability of treatment weighting analysis.

An 'ideal candidate for ablation' according to the BCLC staging system may not be an ideal candidate for MWA. However, patients with BCLC-0 may be the optimal population for MWA.

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The association of non-alcoholic fatty liver disease between parents and adolescent children.

Adolescent children with a parent with NAFLD were at increased risk of NAFLD; risk was higher when both parents had NAFLD. Further studies are needed to explore the benefit of NAFLD screening in children who have a parent with NAFLD.

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Am J Gastroenterol

Comparable mortality between Asian chronic hepatitis B patients under long-term antiviral therapy vs. matched control: a population-based study.

Although the CHB-AVT group was more likely to develop HCC than the matched general population (aHR 13.16, 95% CI: 10.90-15.89; p <0.001), the non-HCC malignancies risk in the CHB-AVT group were comparable to the matched general population (aHR 1.05, 95% CI 0.98-1.13; p =0.137). CHB-AVT group had a similar risk of all-cause mortality and non-HCC malignancies and a lower risk of CVD than the matched general population.

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Use of Benzodiazepines and Z-Drugs in Inflammatory Bowel Disease.

The use of BZD is more common in people with IBD than in population controls. Strategies to reduce the use of BZDs in persons with IBD and to offer alternative management strategies for M/ADs, sleep disorders, and other symptomatic concerns are needed.

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Clin Gastroenterol Hepatol

Adenoma Detection Rate and Clinical Characteristics Influence Advanced Neoplasia Risk after Colorectal Polypectomy.

Colonoscopist ADR is associated with MAN. Combining clinical factors and ADR for risk stratification has potential to improve post-polypectomy risk stratification. Improving ADR is likely to improve post-polypectomy outcomes.

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COMBINATION THERAPY WITH IMMUNOMODULATORS IMPROVES THE PHARMACOKINETICS OF INFLIXIMAB BUT NOT VEDOLIZUMAB OR USTEKINUMAB.

Achieving higher 6-TGN levels or the use of methotrexate improved the pharmacokinetics of infliximab. Conversely, these data do not support the use of combination therapy to augment pharmacokinetics with vedolizumab or ustekinumab.

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IMPROVING THE DIAGNOSTIC YIELD OF HIGH-RESOLUTION ESOPHAGEAL MANOMETRY FOR GERD: THE "STRAIGHT LEG-RAISE" INTERNATIONAL STUDY.

Hiatal hernia (EGJ type 2-3) was seen in 135 (46%) patients. Compared to patients with AET 6% CONCLUSIONS: The SLR maneuver can predict abnormal AET, thereby increasing the diagnostic value of HRM when GERD is suspected.

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Long-term gastrointestinal sequelae following COVID-19: A prospective follow-up cohort study.

COVID-19 led to significantly higher number of new onset PI-FGID/DGBI compared to healthy controls at 3 and 6 months of follow-up. If further investigated some patients can be diagnosed with underlying malabsorption.

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Routine molecular profiling in both resectable and unresectable pancreatic adenocarcinoma: relevance of cytological samples.

Our findings demonstrate the feasibility of an NGS approach using both surgical specimens and cytological samples. The model proposed in this study can be successfully included in the clinical setting for comprehensive molecular profiling of al PDAC patients irrespective of their surgery eligibility.

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Gastroenterology

G9a Modulates Lipid Metabolism in CD4 T cells to Regulate Intestinal Inflammation.

G9a inhibition promotes cholesterol metabolism in T cells favoring a metabolic profile that facilitates Treg development in vitro and in vivo. Our data support the potential use of G9a inhibitors in the treatment of immune-mediated conditions including inflammatory bowel disease.

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Intestinal barrier healing is superior to endoscopic and histologic remission for predicting major adverse outcomes in IBD: the prospective ERIca trial.

Barrier healing is associated with decreased risk of disease progression in clinically remittent IBD patients with superior predictive performance compared to endoscopic and histologic remission. Analysis of barrier function might be considered as a future treatment target in clinical trials.

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Gastrointest Endosc

Development and Validation of Artificial Neural Networks Model for Detection of Barrett's Neoplasia, a Multicenter Pragmatic Non-Randomized Trial.

In phase 3, the CADe system detected Barrett's neoplasia with sensitivity, specificity, NPV and accuracy of 93.8%, 90.7%, 95.1% and 92.0% respectively compared to the endoscopists' performance of 63.5%, 77.9%, 74.2% and 71.8% respectively (p 90% sensitivity for neoplasia detection. This needs to be validated during real-time endoscopic assessment.

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Diagnostic yield and technical performance of novel motorized spiral enteroscopy compared to single-balloon enteroscopy in suspected Crohn's disease: a prospective study (with videos).

Both NMSE and SBE are safe and effective for small bowel evaluation in suspected CD. NMSE scores over SBE with regards to deeper small bowel evaluation with complete small bowel coverage and shorter procedure time.

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Technical Details and Outcomes of Peroral Endoscopic Myotomy with Fundoplication: The First U.S. Experience.

This first case series on POEM-F in the U.S. suggests that POEM-F is feasible and safe with excellent short-term outcomes.

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Gut

Rewiring the altered tryptophan metabolism as a novel therapeutic strategy in inflammatory bowel diseases.

Our study identified a new mechanism linking Trp metabolism to intestinal inflammation and IBD. Bringing back XANA and KYNA has protective effects involving AhR and the rewiring of the energy metabolism in intestinal epithelial cells and CD4 + T cells. This study paves the way for new therapeutic strategies aiming at pharmacologically correcting its alterations in IBD by manipulating the endogenous metabolic pathway with AADAT.

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Targeting tumour-intrinsic N7-methylguanosine tRNA modification inhibits MDSC recruitment and improves anti-PD-1 efficacy.

Our data uncover novel mechanisms underlying chemokine regulation and TIME shaping at the layer of messenger RNA translation level and provide new insights for development of efficient cancer immunotherapeutic strategies.

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Neurogastroenterol Motil

Chronic jetlag reprograms gene expression in the colonic smooth muscle layer inducing diurnal rhythmicity in the effect of bile acids on colonic contractility.

Chronodisruption abolished the rhythm in bile acid levels which might contribute to a shift in smooth muscle clock gene expression. Our findings suggest that chronodisruption caused a transcriptional reprogramming in the colonic smooth layer thereby inducing a rhythm in the expression of Gpbar1 and in the inhibitory effect of TDCA on colonic contractility.

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Heterozygous Actg2R257C mice mimic the phenotype of megacystis microcolon intestinal hypoperistalsis syndrome.

A mouse model demonstrating MMIHS-like symptoms was generated. The Actg2 R257C heterozygous variant impairs SMCs contraction by interfering with actin polymerization, leading to GI motility disorders.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: 5-aminosalicylic acid fails to impact on irritable bowel syndrome-wrong population, intervention, target or hypothesis?

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Editorial: autoimmune hepatitis and metabolic syndrome-associated disease development-an important question but only part of the answer?

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Editorial: differences in altered duodenal T-cell immunology in alcoholic liver damage versus NAFLD.

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Clin Gastroenterol Hepatol

Immune Checkpoint inhibitor Enterocolitis vs Idiopathic Inflammatory Bowel Disease.

Clinical and endoscopic presentation of both entities is strikingly similar which often guides management. Though well established in IBD, little is known about the long term outcomes of IMEC.

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Gastroenterology

Infliximab and tofacitinib attenuate neutralizing antibody responses against SARS-CoV-2 ancestral and Omicron variants in IBD patients following 3 doses of COVID-19 vaccine.

Pubmed   Journal   ReadQx   PMC

Gastrointest Endosc

Reduction in mortality after percutaneous endoscopic gastrostomy tube insertion is likely due to careful patient selection.

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J Hepatol

Primary biliary cholangitis as a roadmap for the development of novel treatments of cholestatic liver diseases.

Obeticholic acid is currently the only approved second line therapy for PBC. Drugs in the late phase of clinical development are the PPAR agonists, NorUDCA and the NOX 1&4 inhibitors.

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Time to focus chronic liver diseases back into the community: A review of primary care hepatology tools, pathways of care and reimbursement mechanisms.

A focus on improving CLD is likely to have wide benefits across co-existing metabolic disorders, particularly when pathways are aligned with community lifestyle support services. The important message for primary care is to increase the value of existing monitoring rather than to generate more work.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

Pleomorphic Hyalinizing Angiectatic Tumor in the Upper Abdomen.

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Clin Gastroenterol Hepatol

Impact of Carcinoid and Appendiceal Site Inclusion on Early-onset Colon Cancer Incidence Rate Analysis.

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Socioeconomic status and ethnic enclave as risk factors for gastric adenocarcinoma in Hispanic and Asian Americans, a CCR analysis.

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Successful Endoscopic Closure of Gastrobronchial Fistula using Polyglycolic Acid Sheets with Fibrin Glue.

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Endoscopy

Over-the-scope clip and self-expandable metal stent: a comprehensive treatment for failed peroral endoscopic myotomy and fibrosis complications in idiopathic achalasia.

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Gastroenterology

A Mysterious Case of Abdominal Pain!

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An unusual case of chest pain and pyrexia.

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An unusual cause of lower gastrointestinal bleed.

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For consideration as Gastro Curbside Consult in Gastroenterology: An unusual cause of diarrhea in young adulthood.

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Identifying Care Challenges as Opportunities for Research and Education in Inflammatory Bowel Disease in South Asia.

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Massive single lesion in a patient with sickle cell disease.

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Pitting Edema in a Patient with Acute Hepatitis B Virus Infection.

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Gastrointest Endosc

Mucin-rich traditional serrated adenoma with dysplasia of the rectum observed by magnifying endoscopy.

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Top Tips in EUS Elastography Cover Page.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Letter: Autoimmune hepatitis and metabolic syndrome-associated disease development - a US cohort study.

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Letter: comedication use and dementia risk in patients with inflammatory bowel disease-authors' reply.

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Letter: comedication use and dementia risk in patients with inflammatory bowel disease.

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Letter: what explains improved survival from statin exposure after liver transplantation?

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Letter: what explains improved survival from statin exposure after liver transplantation? Authors' reply.

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Gastroenterology

Correspondence to "TENSION Trial to ExTENSION Study: Has extension decreased tension?" by Tiwari et al. Gastroenterology 2022.

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Letter to the Editor regarding "The Rising Burden of Inflammatory Bowel Disease in Denmark over Two Decades: A Nationwide Cohort Study" by Agrawal et al.

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Microbial Riboflavin Biosynthesis Associates with Response to Dietary Fiber Consumption: Time to Personalize Adjunct Therapy in Patients with Inflammatory Bowel Disease?

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Gastrointest Endosc

A few considerations for follow-up surveillance colonoscopy.

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Duodenal mucosal resurfacing before its use in clinical practice.

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Endoscopic ultrasonography: Complementary or alternative to radiology in evaluating pancreatic cystic neoplasms?

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Endoscopic vacuum therapy in the treatment of postesophagectomy leaks: Is intracavitary the way?

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Gut

Most excess years of potential life loss among individuals with cirrhosis during the pandemic were not related to COVID-19.

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